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  #1  
Old 09-12-2012
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Question Three Step 1 Questions

26-y.o. woman has not had a menstrual period for 3 months. (Menarch age: 13; previous menses: regular, 30-day intervals) Mother died from breast cancer 2 weeks ago, and the pt. spent the past year taking care of her. Pt. has not eaten well since her mother's death. Pt. also has altered sleep and 15-lb. weight loss over the past year. Exam: normal-sized uterus, negative pregnancy test. Which of the following is the most likely cause of her secondary amenorrhea?

A. Altered GnRH-pulses
B. Altered prolactin release
C. Increased estrogen and progesterone serum concentration
D. Insufficient cholesterol to produce sex hormones
E. Premature ovarian failure


3-month old boy brought in d/t marked irritability since birth. He breast-feeds well, but becomes fretful, tremulous, and pale 3-4 hours after feeding. P/E: fat cheeks, protruberant abdomen, massive hepatomegaly. 4 hrs after feeding serum studies: hypoglycemia, ketonemia, hypercholesterolemia, lactic acidosis. Following glucagon administration, glucose does not increase; lactic acid does increase. Which of the following ezyme-activity is decreased?

A. Fructose-1,6-BP
B. Galactose-1-P Uridyltransferase
C. G-6-Phosphatase
D. Alpha-1,4-Glucosidase
E. MCAD


Research team wants to evaluate the association b/w asbestos exposure and mesothelioma. Which study design is most appropriate?

A. Case-control
B. Case series
C. Ecologic
D. Randomized clinical trial
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Old 09-12-2012
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i'm not sure abt the answers

1) a) altered GnRH levels-----thinking it as anorexia nervosa leading to amenorrhea

2) c) glucose 6 phosphatase----thinking of vongierke's from his symptoms----4 hrs after eating symptoms,lactic acidosis,hepatomegaly
and eliminating others....MCAD( ketones decrease), GPUT( present with infantile cataracts) , pompe(cardiomyopathy) ,fructose 1,6 BP( nothing to do with glycogen)

3) a) case control-----but i'm not sure-----thinking of can't be RCT and case series.....but can be ecological( if evaluating at the point of time)
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Old 09-12-2012
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Not sure but...
1) a or c.
2) c
3) a
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Old 09-12-2012
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Quote:
Originally Posted by venky2600 View Post
i'm not sure abt the answers

1) a) altered GnRH levels-----thinking it as anorexia nervosa leading to amenorrhea

2) c) glucose 6 phosphatase----thinking of vongierke's from his symptoms----4 hrs after eating symptoms,lactic acidosis,hepatomegaly
and eliminating others....MCAD( ketones decrease), GPUT( present with infantile cataracts) , pompe(cardiomyopathy) ,fructose 1,6 BP( nothing to do with glycogen)

3) a) case control-----but i'm not sure-----thinking of can't be RCT and case series.....but can be ecological( if evaluating at the point of time)

Agreed
1.Aa..hypogonaddotrophic amenorrhea.anorexia cause low LH,FSH,estradiol etc
2.Cc..von gierkes dx
3.Aa..case control study..retrospective exposure with outcome
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Old 09-13-2012
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Quote:
Originally Posted by mayan5252 View Post
26-y.o. Woman has not had a menstrual period for 3 months. (menarch age: 13; previous menses: Regular, 30-day intervals) mother died from breast cancer 2 weeks ago, and the pt. Spent the past year taking care of her. Pt. Has not eaten well since her mother's death. Pt. Also has altered sleep and 15-lb. Weight loss over the past year. Exam: Normal-sized uterus, negative pregnancy test. Which of the following is the most likely cause of her secondary amenorrhea?

a. altered gnrh-pulses
b. altered prolactin release
c. increased estrogen and progesterone serum concentration
d. insufficient cholesterol to produce sex hormones
e. Premature ovarian failure


3-month old boy brought in d/t marked irritability since birth. He breast-feeds well, but becomes fretful, tremulous, and pale 3-4 hours after feeding. P/e: Fat cheeks, protruberant abdomen, massive hepatomegaly. 4 hrs after feeding serum studies: hypoglycemia, ketonemia, hypercholesterolemia, lactic acidosis. Following glucagon administration, glucose does not increase; lactic acid does increase. Which of the following ezyme-activity is decreased?

a. Fructose-1,6-bp
b. Galactose-1-p uridyltransferase
c. G-6-phosphatase
d. Alpha-1,4-glucosidase
e. Mcad


research team wants to evaluate the association b/w asbestos exposure and mesothelioma. Which study design is most appropriate?

a. Case-control
b. Case series
c. Ecologic
d. Randomized clinical trial
a ... C .... A ....
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  #6  
Old 09-13-2012
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Quote:
Originally Posted by mayan5252 View Post
26-y.o. woman has not had a menstrual period for 3 months. (Menarch age: 13; previous menses: regular, 30-day intervals) Mother died from breast cancer 2 weeks ago, and the pt. spent the past year taking care of her. Pt. has not eaten well since her mother's death. Pt. also has altered sleep and 15-lb. weight loss over the past year. Exam: normal-sized uterus, negative pregnancy test. Which of the following is the most likely cause of her secondary amenorrhea?

A. Altered GnRH-pulses
B. Altered prolactin release
C. Increased estrogen and progesterone serum concentration
D. Insufficient cholesterol to produce sex hormones
E. Premature ovarian failure


3-month old boy brought in d/t marked irritability since birth. He breast-feeds well, but becomes fretful, tremulous, and pale 3-4 hours after feeding. P/E: fat cheeks, protruberant abdomen, massive hepatomegaly. 4 hrs after feeding serum studies: hypoglycemia, ketonemia, hypercholesterolemia, lactic acidosis. Following glucagon administration, glucose does not increase; lactic acid does increase. Which of the following ezyme-activity is decreased?

A. Fructose-1,6-BP
B. Galactose-1-P Uridyltransferase
C. G-6-Phosphatase
D. Alpha-1,4-Glucosidase
E. MCAD


Research team wants to evaluate the association b/w asbestos exposure and mesothelioma. Which study design is most appropriate?

A. Case-control
B. Case series
C. Ecologic
D. Randomized clinical trial
a
c
a........
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  #7  
Old 09-13-2012
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Ya will also go with
A
C
A but cohert study would be more appropriate


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